After a first reading of Steinkuller's article, I nodded approvingly. I reflected back on Alex Kotlowitz's There Are No Children Here, a book that made Steinkuller's point compellingly real. But, then, I reread the article and shared it with a colleague. It became clear to me that Steinkuller's point was essential and one not often made in the pediatric literature; still, more needed to be said.

The "more" requires elaboration of Steinkuller's last two or three sentences. She indicates that we might reach a time when "we can be confident that the pediatricians of the 21st century will care enough to get involved, protect our young people from drugs and violence, and bring hope once again to America's children." It is that involvement that needs to be emphasized. It demands more than simply an understanding of the problem. It requires that the pediatrician get out of the emergency department, out